Bootsoa bo Inthaneteng: Seo re se Tsebang le Seo re sa se Tsebeng - Tlhahlobo ea Ts'ebetso (2019)

LINKA HO ETSA TLHOTSO TSE FELENG

Clin. Moedi 2019, 8(1), 91; Doi:10.3390 / jcm8010091

Rubén de Alarcón 1 , Javier I. de la Iglesia 1 , Nerea M. Casado 1 'me Angelo L. Montejo 1,2,*

1 Tšebeletso ea kelello, Sepetlele Clínico Universitario de Salamanca, Setsi sa Patlisiso ea Biomedical ea Salamanca (IBSAL), 37007 Salamanca, Spain

2 Univesithi ea Salamanca, EUEF, 37007 Salamanca, Spain

inahaneloang

Lilemong tse 'maloa tse fetileng, ho bile le leqhubu la lingoliloeng tse amanang le bokhoba ba boitšoaro; tse ling tsa tsona li shebile ho lemalla lithethefatsi tsa bootsoa inthaneteng. Leha ho le joalo, ho sa natse boiteko bohle, re ntse re sa khone ho hlahisa maikutlo ha ho etsa boitšoaro bona ho fetoha ho ts'oaroang. Mathata a tloaelehileng a kenyelletsa: mohlala oa leeme, ho batla lisebelisoa tsa tlhahlobo ea mali, ho hanana le taba, le taba ea hore karolo ena e ka akaretsoa kahare ho psychology e kholo haholo (ke hore, tlhekefetso ea thobalano) e ka iponahatsang ka matšoao a fapaneng haholo. Litlokotsi tsa boitshwaro li etsa karolo ea thuto e sa abeloang haholo, 'me hangata e bontša mofuta oa tšebeliso ea mathata: tahlehelo ea taolo, ho senyeha le ts'ebeliso e kotsi. Hypersexual disorder e tšoanela mohlala ona mme e kanna ea etsoa ka boitsoaro bo fapaneng ba thobalano, joalo ka ts'ebeliso e mpe ea ts'ebeliso ea litšoantšo tsa bootsoa inthaneteng (POPU). Ts'ebeliso ea litšoantšo tsa bootsoa inthaneteng e ntse e eketseha, 'me monyetla oa ho lemalla ho nahana ka tšusumetso ea "makhetlo a mararo" (ho fumaneha, ho ba bonolo, ho se tsejoe). Ts'ebeliso ena e nang le mathata e kanna ea ba le litlamorao tse matla kholisong ea thobalano le ts'ebetso ea thobalano, haholoholo hara bacha. Re ikemiselitse ho bokella tsebo e teng mabapi le tšebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro marang-rang e le ntho e reretsoeng ho bolaea. Mona re leka ho akaretsa ka seo re se tsebang ka mokhatlo ona mme re hlalose libaka tse ling tse lokelang ho etsoa lipatlisiso tse ling.
Mantsoe a bohlokoa: litšoantšo tsa bootsoa tse fumanehang marang-rang; temallo; cybersex; marang-rang; boitšoaro bo qobelloang ba thobalano; Hypersexourse

1. Selelekela

Ka ho kenyelletsoa ha ho na le mathata a "papali ea papali ea chelete ea" papali ea chelete "Khaolong ea" Tšebeliso ea lithethefatsi le likhathatso tse tlatsetsang "DSM-5 [1], APA e ile ea lumela phatlalatsa semelo sa bokhoba ba boitšoaro. Ntle le moo, "Internet Gaming Disorder" e ile ea kenngoa Karolo ea 3Mekhoa ea ho ithuta ka ho eketsehileng.
Sena se emela phetoho e tsoelang pele ea paradigm lebaleng la lithethefatsi tse amanang le boitšoaro ba bokhoba, 'me e bula tsela bakeng sa lipatlisiso tse ncha ka lebaka la liphetoho tsa setso tse bakiloeng ke mahlale a macha.
Kamoo ho bonahalang kateng ho na le neurobiological e tloaelehileng e teng [2] le tikoloho [3] sebaka pakeng tsa mathata a fapaneng a bokhoba ba ho lemalla, ho kenyeletsa le tšebeliso e mpe ea lithethefatsi le boitšoaro ba ho lemalla; hona ho ka bonahala e le ho pharalla ha lintho ka bobeli [4].
Ka tloaelo, batho ba lemaletseng boitšoaro ba tšohanyetso khafetsa ba bonts'a mokhoa o sebelisang mathata: taolo e senyehileng (mohlala, ho lakatsa, liteko tse sa atleheng tsa ho fokotsa boitšoaro), ho senyeha (mohlala, ho fokotsa litabatabelo, ho se tsotelle likarolo tse ling tsa bophelo), le ts'ebeliso e kotsi tlhokomeliso ka litlamorao tse senyehileng tsa kelello). Hore na boits'oaro bona bo kopana le litekanyetso tsa mmele tse amanang le bokhoba ba mamello (mamello, ho se tlose) ho tšoarana haholo [4,5,6].
Hypersexual disc ka linako tse ling e nkuoa e le e 'ngoe ea litheko tsa boits'oaro. E sebelisoa e le sekhele sa meaho se akaretsang boits'oaro bo fapaneng ba mathata (ho ipholla litho tsa botona kapa botšehali, cybersex, ts'ebeliso ea litšoantšo tsa botona le botšehali, thobalano ea mohala, boitšoaro ba thobalano le batho ba baholo ba lumellang, ketelo ea sehlopha sa metsero, jj.) [7]. Tekanyetso ea eona ea phallo e tloha ho 3% ho 6%, leha ho le thata ho tseba hobane ha ho na tlhaloso e hlakileng ea lefu lena [8,9].
Ho haella ha tlhaiso-leseling ea mahlale a matla ho etsa hore lipatlisiso tsa eona, conceptualization, le tlhahlobo li be thata, e lebise ho litlhahiso tse fapaneng tsa ho e hlalosa, empa hangata e amana le khatello ea maikutlo, maikutlo a lihlong le ho hloka kelello kelellong [8], hammoho le mekhoa e meng e lemalloang [10] 'me e tiisa tlhahlobo e tobileng.
Ka nako e tšoanang, ho phahama ha mahlale a macha ho boetse ho buletse tsela ea mathata a ho lemalla, haholo ho lemalla lithethefatsi Inthaneteng. Tlatsetso ena e ka shebisa ts'ebetso e khethehileng ho marang-rang (lipapali, ho reka, ho becha, cybersex…) [11] ka menyetla ea boits'oaro bo kenyang kotsi; khetlong lena, e tla sebetsa e le mocha oa lipontšo tse hlakileng tsa boitšoaro bo boletsoeng [4,12]. Hona ho bolela ho eketseha ho sa qojoe, ho fana ka mabenkele a macha bakeng sa lithethefatsi tse ikemiselitseng hammoho le batho ba hohelang (ka lebaka la boitsebelo bo eketsehileng, kapa monyetla) bao ba ka beng ba sa ka ba kopanela boits'ebetsong bona.
Ts'ebeliso ea litšoantšo tsa bootsoa inthaneteng, e tsejoang hape ka tšebeliso ea litšoantšo tsa bootsoa Inthaneteng kapa cybersex, e ka ba e 'ngoe ea boitšoaro bo ikhethileng ba marang-rang ba nang le kotsi ea ho lemalla. E tsamaisana le ts'ebeliso ea inthanete ho etsa liketso tse fapaneng tsa khotsofalo tsa thobalano.13], eo ho eona ho nang le ts'ebeliso ea litšoantšo tsa bootsoa [13,14] e leng ketsahalo e tummeng haholo [15,16,17] ka palo e sa feleng ea maemo a thobalano a fumanehang [13,18,19,20]. Tšebeliso e tsoelang pele ka mokhoa ona ka linako tse ling e hlaha mathateng a lichelete, molao, mosebetsi le mathata a kamano [6,21] kapa mathata a botho, a nang le litlamorao tse fapaneng. Maikutlo a ho lahleheloa ke taolo le tšebeliso e phehellang leha litholoana tsena li le mpe "e le tlamo ea thobalano marang-rang" [22] kapa Ts'ebeliso e Mpe ea Litšoantšo tsa Bootsoa Inthaneteng (POPU). Moetso ona o nang le mathata o sebelisa melemo ea "Triple A" [23].
Ka lebaka la mohlala ona, ho ipholla litho tsa botona kapa botšehali ho amanang le litšoantšo tsa bootsoa e kanna ea ba teng matsatsing ana, empa sena ha se bolele hore ke pherekano ea mafu a kelello [21]. Rea tseba hore karolo e kholo ea bacha ba banna e fihlella inthanete bakeng sa tšebeliso ea litšoantšo tsa bootsoa [24,25]; ha e le hantle, ke e 'ngoe ea mehloli ea bona ea bohlokoa bakeng sa bophelo bo botle ba thobalano.26]. Ba bang ba bontšitse ho tšoenyeha ka sena, ba rarolla lekhalo le pakeng tsa ha litšoantšo tsa bootsoa li sebelisoa ka lekhetlo la pele, le boiphihlelo ba pele ba thobalano; ka ho otloloha, hore na ea pele e ka ba le tshusumetso joang ntlafatsong ea thobalano [27] joalo ka takatso e tlase haholo ea thobalano ha o sebelisa litšoantšo tsa bootsoa Inthaneteng [28] le ho se sebetse hantle ha erectile, e ileng ea ipha matla haholo har'a banna ba lilemong tse 'maloa tse fetileng ha ho bapisoa le lilemong tse mashome tse' maloa tse fetileng.29,30,31,32,33].
Re shebile ka nepo lingoliloeng tse seng li le teng ka taba ea POPU ho leka le ho akaretsa tsoelopele e sa tsoa etsoa mabapi le lefu la mafu a tšoaetso, lipontšo tsa bongaka, bopaki ba ts'ehetso ea methapo bo ts'ehetsang mofuta ona oa ts'ebeliso ea mathata, concepicization ea eona mabapi le ts'oaetso ea hypersexual, tlhahlobo ea eona e reriloeng lisebelisoa le maano a kalafo.

2. Mekhoa

Re entse tlhahlobo e hlophisehileng e latelang likeletso tsa PRISMA (Setšoantšo sa 1). Ha re fana ka bopaki bo bocha ba taba ena mabapi le taba ena, re ile ra etsa tlhahlobo ea rona re sa ikhethile ka nako. Ho ile ha beoa pele ho litlhahlobo tsa lingoliloeng le lingoloa tse phatlalatsoang ka mokhoa o mocha oa khale, haholo pele bakeng sa litlhahlobo tse seng li hatisitsoe ka taba ena. PubMed le Cochrane e ne e le li-database tsa mantlha tse sebelisitsoeng, leha ho le joalo, lingoliloeng tse ngata li ile tsa hlophisoa ka ho etsa litšupiso.
Jcm 08 00091 g001 550
Setšoantšo sa 1. PRISMA flow flow.
Kaha maikemisetso a rona e ne e le litšoantšo tsa bootsoa tse fumanehang marang-rang le boitšoaro bo bobe ba likamano tsa botona le botšehali, re ile ra qhelella ka thoko lingoliloeng tseo re neng re ka li shebella feela ha re ntse re li batla: tse amanang le tšebeliso e mpe ea inthanete, tseo li shebaneng le litšoantšo tse ts'oanang tsa litšoantšo tsa bootsoa, ​​le tse ling. o ile a bua ka taba ena ka mokhoa oa sechaba.
Mabitso a latelang a patlo le lihlahisoa tsa bona li sebelisitsoe ka mefuta e mengata: cybersex, porn * (ho lumella "litšoantšo tse litšila tse tsosang takatso" le "litšoantšo tse manyala tse hlephisang boitšoaro"), inthaneteng, marang-rang. , thobalano, thobalano e qobelloang, hypersexuality. Sesebelisoa sa taolo ea tataiso Zotero e sebelisitsoe ho aha database ea litaba tsohle tse nahanoang.

3. Liphetho

3.1. Epidemiology

Ts'ebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro ho batho ka kakaretso e bonts'a ho le thata ho lekanngoa ka nepo, haholoholo ho tloha ho phahama ha marang-rang le lintlha tsa "makhetlo a mararo" tse lumelletseng ho ba boinotšing le ho ba bonolo ho fihlella. Phuputso ea Wright mabapi le tšebeliso ea litšoantšo tsa bootsoa ho banna ba banna ba US ba sebelisang General Social Survey (GSS) [34], le Phuputso ea Price (e atolosang ho Wright's ka ho khetholla pakeng tsa lilemo, cohort, le litlamorao tsa nako) [35e theha tse ling tsa tse 'maloa, haeba e se tsona feela mehloli e teng e latelang tšebeliso ea litšoantšo tse litšila tse ts'oanang le batho ka kakaretso. Li bonts'a tšebeliso e ntseng e eketseha ea litšoantšo tsa bootsoa ka lilemo, haholoholo hara banna ba banna ho fapana le basali. Sena se atile haholo har'a batho ba baholo ba banyenyane, mme e ntse e fokotseha le lilemo.
Ho na le lintlha tse khahlisang tse mabapi le tšebeliso ea litšoantšo tse litšila tse tsosang takatso. E 'ngoe ea tsona ke hore sehlopha sa banna ba 1963 le 1972 se bontsitse ho fokotseha ho fokolang ha ts'ebeliso ea bona ho tloha selemong sa 1999 ho ea pele, ba fana ka maikutlo a hore tšebeliso ea porno har'a lihlopha tsena e lutse e sa khaotse ho tloha ho [35]. E 'ngoe hape ke hore 1999 hape ke selemo mokhoa oo basali ba lilemo li 18 ba 26 ba jang litšoantšo tsa bootsoa ba ileng ba fetoha makhetlo a mararo ho feta ba neng ba le lilemo li 45 ho 53, ho fapana le ka makhetlo a mabeli ka moo ba neng ba le ka teng ho fihlela moo [35]. Lintlha tsena tse peli li ka amana le ho fetoha le litloaelo tsa ts'ebeliso ea lits'oants'o tsa bootsoa tse susumetsoang ke mahlale (ho feto-fetoha ntle ho marang-rang ho ea ho mofuta oa ts'ebeliso ea marang-rang), empa ho ke ke ha khoneha ho tseba ka 'nete kaha data ea pele ha e bake karohano ho tsa marang-rang le tsa marang-rang. ho fapana ha ho latela ts'ebeliso ea litšoantšo tsa bootsoa.
Ha e le POPU, ha ho na datha e hlakileng le e tšepahalang ho lingoliloeng tse hlahlojoang tse ka fanang ka tekanyetso e tiileng ea ho ata ha eona. Ho kenyelletsa sepheo se seng se boletsoe sa ho haella ha tlhaiso-leseling mabapi le tšebeliso ea litšoantšo tse litšila tse ts'oanang tsa litšoantšo tsa bootsoa, ​​karolo e 'ngoe ea eona e ka hlaha ka lebaka la taba eo ho buuoang ka eona ke ba nkang karolo, bongata ba lisebelisoa tsa tlhahlobo tse sebelisitsoeng ke bafuputsi, le tlhokahalo ea tumellano ka seo ha e le hantle e leng tšebeliso ea ts'ebetso ea litšoantšo tsa bootsoa, ​​tseo e leng lintlha tsohle tse hlahang hape leseling lena.

Boholo ba lithuto tse amanang le POPU kapa boitšoaro bo atisang ho sebetsa li sebelisa mehlala e bonolo ho e lekanya, hangata e fumana, leha ho na le phapang ea palo ea batho, hore basebelisi ba fokolang haholo ba nka tloaelo ena e le temallo, mme leha ba e etsa, le ba fokolang ba nka hore sena se ka ba le phoso. phello ho tsona. Mehlala e meng:

(1) Phuputso e lekang litekanyetso tsa boits'ebetso har'a basebelisi ba lithethefatsi, e fumane hore ke 9.80% feela ho barupeluoa ba 51 ba hlokometseng hore ba na le temallo ea thobalano kapa litšoantšo tsa bootsoa [36].

(2) Phuputso ea Sweden e amohetseng sampuli ea barupeluoa ba 1913 ka lipotso tsa marang-rang, 7.6% e tlaleha bothata bo bong ba thobalano ba marang-rang mme 4.5% e bontšitse maikutlo a ho 'lemalla' marang-rang bakeng sa lerato le merero ea thobalano, le hore ona e ne e le 'bothata bo boholo' [17].

(3) Phuputso ea Sepanishe e nang le sampole ea baithuti ba koleche ea 1557 e fumane hore 8.6% e ne e le kotsing ea ho theha ts'ebeliso ea ts'ebetso ea litšoantšo tsa bootsoa marang-rang, empa hore ts'ebetso ea ts'ebeliso ea "pathological" e ne e le 0.7% [37].

Phuputso e le 'ngoe feela e nang le sampole ea baemeli ho fihlela joale ke ea Australia, e nang le sampuli ea barupeluoa ba 20,094; 1.2% ea basali ba hlahlobiloeng ba inka e le lithethefatsi, athe ho banna e ne e le 4.4% [38]. Phumano e ts'oanang e sebetsa le ho boitsoaro bo litšila ntle le litšoantšo tsa bootsoa [39].
Barekisi ba boitšoaro bo hlephileng ba thobalano le ts'ebeliso ea litšoantšo tse litšila tse tsosang takatso ea ho sheba litšoantšo tse litšila tse tsosang takatso ke lintho tse fumanehang hohle: ho ba monna, lilemo tse ncha, tumelo, tšebeliso ea Inthanete khafetsa, maemo a nyahamisang a maikutlo, le ho ba le tloaelo ea ho ba le letsoalo la thobalano, le ho batla bocha [17,37,40,41]. Tse ling tsa mabaka ana a kotsi le tsona li arolelanoa ke bakuli ba boitšoaro bo feteletseng [39,42].

3.2. Ethopathogenical and Diagnostic Conceptualization

Ho nahana ka boitšoaro ba pathological bo ntse bo thatafala le kajeno. Ha ho ntse ho etsoa liteko tse 'maloa mabapi le boitšoaro bo amanang le boitšoaro bo bongata, ho haella ha tlhaiso-leseling e matla joalo ka ha joale ho hlalosa taba ea hore ha ho lumellanoe ka taba ena [9]. POPU e na le mefuta e ikhethileng ea boitšoaro ba thobalano bo kenyelletsang theknoloji. Ka lebaka la ts'ebeliso ea mathata a thekenoloji (haholoholo theknoloji ea inthaneteng) haufinyane, re hloka pele ho bua ka boitšoaro bo amanang le hypersexual bo sa amaneng le theknoloji e le hore re utloisise sebaka sa litšoantšo tsa bootsoa tsa inthanete ho eona.
Thobalano joalo ka boits'oaro e atile haholo, 'me lehlakore la eona la thuto-kholo le ithutile ka makholo a lilemo [43]. Ka hona, e emela phephetso ho mehlala e lekang ho e hlalosa ka mokhoa o nepahetseng, hobane e ka kenyelletsa mekhoa e simolohang ho tloha ho nahana ka bosoha le pefo ea thobalano [21]. Ho boetse ho thata ho hlalosa hore na ho se sebetse hantle ke eng le ho khona ho qoba tšebeliso e mpe ea tlhaloso eo ho nyenyefatsa le ho ts'oara batho ka bomong [44]. Mohlala, ba bang ba behile moeli lipakeng tsa boitšoaro bo tloaelehileng ba thobalano le ts'ebetso ea thobalano ho li-orgasms tse fetang tse supileng ka beke [43] (leq. 381), empa mokhoa ona o shebaneng le boholo ba ona o ka ba kotsi, hobane boits'oaro bo tloaelehileng le ba ts'ebetso ea methapo ea methapo bo ka fapana haholo lipakeng tsa batho. Ho haelloa ke ho tšoana le ho tenyetseha ha mofuta oa ona ho ka sitisa lipatlisiso tsa nako e tlang mabapi le ho etsa lipatlisiso ka boitšoaro bo feteletseng [45] mme o hlokomolohe likarolo tsa boleng tse shebaneng le maikutlo a mabe a amanang le ona [46,47]. Ho bile le litlhahiso tsa ho lopolla bothata bona ho sebelisoa lisebelisoa tse itseng, tse seng li nts'itsoe e le karolo ea tlhahiso ea khatello ea maikutlo e sebelisitsoeng tekong ea lebala la DSM-5 [43,47].
Hypersexuality ka kakaretso e sebetsa joalo ka sekhele se hahiloeng [7]. Nomenclature ea eona e ntse e le taba ea ngangisano ho fihlela kajeno, 'me e lula e kopana le mantsoe a' maloa a lebisang mohopolo o le mong: boitšoaro bo qobelloang ba thobalano, ho lemalla ho kopanela liphate, ho tsosa takatso ea botona kapa ea botšehali. Bangoli ba bang, ha ba ntse ba lemoha bohlokoa ba mantsoe "bokhoba" le "ho qobelloa", ba khetha ho lebisa tlhokomelo ho taba ea taolo le tahlehelo ea eona kapa ho inehela e le taba ea mantlha mabapi le boitšoaro bona, ka hona ba re ke "ntle ho taolo" boitšoaro ba thobalano ”[45,48,49].
Le ha litlhaloso li sa tšoane, hangata li lebisa tlhokomelo khafetsa kapa botebong ba matšoao [46] ea litakatso tse tloaelehileng le litoro tse fapaneng, tse ka lebisang ho se sebetse. Sena se e khetholla ho boitsoaro bo bobe ba ho kopanela likobo, leha tlhoko ea ho hlakisoa ka nepo ea liphapang tse ka bang teng, ho ts'oana, le ho feta lipakeng tsa mefuta e 'meli ho ntse ho phehella [45].
Hangata ho kenyelletsoa boits'oarong bo litšila ke ho ipholla litho tsa botona kapa botšehali le boits'oaro bo fapaneng bo amanang le thobalano, joalo ka ho its'etleha ka likamano tsa thobalano tse sa tsejoeng, boitšoaro bo bobe ba ho pheta-pheta, litšoantšo tsa bootsoa tsa inthanete, thobalano ea mohala le ho etela lihlopha tse marang-rang.43,44,49,50,51]. Bancroft o nahanne haholo hore, ka ho sebelisa marang-rang, ho ipholla litho tsa botona kapa botšehali le liketso tsena tsa thobalano ho ka ikopanya, a re banna "ba e sebelisa joalo ka ha e se na moeli oa matla a bona a taolo ea boitšoaro ba thobalano".
Leha monyetla oa ho fumana hore na boitšoaro bo amanang le boitšoaro bo bobe bo ne bo lula bo le teng ka lebaka la "tlhekefetso ea thobalano e sa hlalosoang ka hosele" ho DSM [1], Kafka [43] e lekile ho e hlahisa e le sesupo sa tlhahlobo bakeng sa DSM-5. O ile a fana ka litekanyetso tsa eona, e le karolo ea khaolo ea thobalano. Mefuta ena e reriloeng e kenyelletsa boitšoaro bo fetelletseng joaloka: (1) takatso ea thobalano, (2) tšebeliso ea litekanyetso tsa boits'oaro, (3) karolo ea bohlasoa bo sa bonahaleng ba tšohanyetso, (4) karolo ea mafu a ho hloka bohlasoa, le (5) " taolong ”boitšoaro bo feteletseng ba ho kopanela liphate. Tlhahiso ena e ile ea qheleloa ka thoko ka lebaka la mabaka a 'maloa; ea ka sehloohong e ne e boleloa e le ho ba sieo ha leseli le kopaneng la lefu la seoa le ho hlaseloa mabapi le boitšoaro bona [52,53], empa hape le monyetla oa eona oa tlhekefetso ea matla a morao-rao, e sa reroang ka ho lekaneng litekanyetso tsa tlhahlobo, le lipolotiki tse ka hlahang lipolotiking le sechabeng tsa pathologizing karolo ea bohlokoa ea boits'oaro bophelong ba motho [54]. Hoa thabisa ho e bapisa le litekanyetso tse ling tse peli tse fetileng tse teng ka har'a lingoliloeng tse hlahlojoang, tsa Patrick Carnes le Aviel Goodman [9]. Ka boraro ba bona ba arolelana mohopolo oa tahlehelo ea taolo, nako e ngata e sebelisoang ka thobalano le litlamorao tse mpe ho ba bang / empa ba iphapanyetsa lintho tse ling. Sena se supa ka ho pharalla ho hloloheloang ha tumellano ea boitšoaro bo fetelletseng ba lilemo le lilemo. Hajoale, likhetho tsa mantlha li etsa tlhahiso ea boitšoaro bo fetelletseng e le bothata ba taolo ea tšusumetso kapa tlhekefetso ea boitšoaro [55].
Ho tloha ka mokhoa oa ho laola maikutlo a ho laola maikutlo, boitšoaro ba hypersexual hangata bo bitsoa Compulsive Sexual Behavior (CSB). Coleman [56] ke mothetsi oa khopolo ena. Ha a ntse a kenyelletsa boitšoaro ba paraphilic tlas'a lentsoe lena [57], 'me ba ka' na ba kopana maemong a mang, o li khetholla ka ho hlaka ho CSB e sa pheleng, e leng seo re batlang ho tsepamisa maikutlo ho sona tlhahlobisong ena. Hoa thahasellisa hore hangata boitšoaro bo bobebe ba ho kopanela liphate ha bo bapisoa le hangata ke ba makhetlo a mangata,43,58].
Leha ho le joalo, litlhaloso tsa morao-rao tsa CSB li atisa ho bua ka boitšoaro bo bongata ba ho kopanela liphate bo ka qobelloang: ho tsejoa ka ho fetisisa ka ho ipholla litho tsa botona kapa botšehali, ho lateloa ke ho sebelisa boitšoaro bo bobe ba ho sheba litšoantšo tse manyala tse hlephisang boitšoaro, le ho kopanela boitšoarong bo hlephisang boitšoaro, le ho ba le likamano tse ngata (22-76%) [9,59,60].
Ha ho ntse ho na le ho totobetseng ho feteletseng ha ho kopanela liphate le maemo a kang ho kula ho feteletseng (OCD) le mathata a mang a ho laola maikutlo [61], ho boetse ho na le likhetho tse ling tse hlaheletseng tse bontšitsoeng: ka mohlala, boitšoaro ba OCD ha bo akarelletse moputso, ho fapana le boitšoaro ba thobalano. Ho feta moo, ha ho e-na le lik'homphieutha ho ka 'na ha fella ka thuso ea nakoana bakeng sa bakuli ba OCD [62], boitšoaro ba ho kopanela liphate hangata bo amahanngoa le boikutlo ba molato le ho ikoahlaea ka mor'a ho etsa ketso [63]. Hape, ho se tsitsisehe hoo ka linako tse ling ho laolang boitšoaro ba mokuli ho sa lumellane le moralo oa tlhokomelo oo ka linako tse ling o o hlokang ho CSB (mohlala, tabeng ea ho kopanela liphate) [64]. Goodman o nahana hore mathata a ho lemalla ho lemalla ho lemalla ho lemala (a amanang le ho fokotsa khatello ea kelello) le mathata a sa tsitsang (a akarelletsang ho khotsofatsa), le matšoao a thehiloeng ke mekhoa ea methapo-hloko (serotoninergic, dopaminergic, noradrenergic, le opioid systems) [65]. Stein o lumellana le mohlala o kopanyang mekhoa e 'maloa ea lits'ebeletso tsa boitšoaro' me o fana ka maikutlo a mofuta oa ABC (khatello ea maikutlo, boitšoaro bo hlephileng ba ho itšoara hampe le dyscontrol ea kutloisiso) ho ithuta mokhatlo ona [61].
Ho latela maikutlo a ho lemalla, boitšoaro ba ho kopanela liphate bo itšetlehile ka ho arolelana lintlha tsa motheo tsa tahi. Lintlha tsena, ho latela DSM-5 [1], lebisa tlhokomelong ea bothata bo boletsoeng ka bothata bo sebelisitsoeng ho boitšoaro ba hypersexual, bobeli ba offline le ba marang-rang [6,66,67]. Bopaki ba ho mamella le ho tlohela bakuli bana e ka 'na ea e-ba ntho ea bohlokoa ho khethollang mokhatlo ona e le lefu la ho lemalla [45]. Tšebeliso e mpe ea cybersex e boetse e atisa ho nkoa e le ho lemalla boitšoaro bo hlephileng [13,68].
Poleloana “ho lemalla” e sebelisang setheo sena e sa ntsane e le ka ngangisano e kholo. Zitzman o nka hore ho hana ho sebelisa temallo ea poleloana ena ke "sesupo sa tokoloho ea botona le botšehali ho feta ho hloka tumellano ea ho ba le matšoao le ho tsebahatsa ka mekhoa e meng ea ho lemalla"69]. Leha ho le joalo, lentsoe lena le hloka ho sebelisoa ka hloko, hobane le ka fetoleloa e le lebaka la ho batla ho se khotsofale le ho natefeloa ke thabo, 'me le behe litholoana tse babang ho tsona.
Ho na le khang e telele lipakeng tsa Patrick Carnes le Eli Coleman mabapi le tlhahlobo ea boitšoaro bo feteletseng. Coleman o nkile bosholu ba maikutlo bo tsamaisoa ke tlhoko ea ho fokotsa mofuta o mong oa matšoenyeho, eseng ka takatso ea thobalano [56] ka mor'a ho e arola ka li-subtypes tse supileng (e 'ngoe ea tsona e le tšebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro marang-rang) [57], ha Carnes (ea hlalositseng bokhoba e le "kamano ea maikutlo le maikutlo a fetohang maikutlo") a fumana papiso lipapatsong tse ling tsa bokhoba ba boits'oaro bo joalo ka papali ea chelete, a shebana le tahlehelo ea taolo le boitšoaro bo tsoelang pele le litlamorao tse mpe [70].
Tlhahlobo e phethahetseng ea lingoliloeng ka Kraus [71], e fihletse qeto ea hore leha ho na le lipapiso tsena, likheo tsa bohlokoa kutlwisisong ea mohopolo li etsa hore sehlopha sa tsona e be leqheka. Matšoenyeho a mantlha a reretsoe ho fihlela bongata ba bongata bo boholo, tlhaiso-leseling ea bongaka (e hlalosang matšoao a mantlha le meeli ea ho hlahloba), e ts'ehetsoeng ke data ea neuropsychological, neurobiological, le genetic, hammoho le tlhaiso-leseling mabapi le tlhahlobo ea kalafo le thibelo, le e supa theknoloji ea dijithale ho boits'oaro bo matla e le ntlha ea bohlokoa bakeng sa lipatlisiso tsa nako e tlang.
Ho phahama ha marang-rang ho eketsa menyetla ea likamano tsa botona le botšehali, eseng feela litšoantšo tsa bootsoa tse fumanehang marang-rang (marang-rang, liwebosaete tsa thobalano tse tloaelehileng). Le ha ts'ebeliso ea inthanete e emela mokhoa oa mefuta e meng ea bo pheta-pheta (mohlala, boitšoaro ba thobalano kapa papali ea chelete) kapa o etsa setheo se fapaneng ka tokelo ea sona o ntse a ngangisana [72]. Leha ho le joalo, haeba nyeoe e le ea pele, bopaki le likhopolo tse fetileng li ka sebetsa hantle ho molekane oa hae oa inthanete.
Hajoale ho na le tlhoko ea litekanyetso tse nkiloeng ka matla tse nkang lintlha tse ikhethileng tsa boits'oaro ba inthanete (bapisoa le inthanete), hobane boholo ba tsona ha li na mofuta oa boits'oaro o ka bapisoang le [73]. Ho fihlela joale, ho bile le mehopolo ea liketsahalo tse ncha ha re sebetsana le boitšoaro ba thobalano marang-rang, joalo ka ho ba teng ha boits'oaro bo inthaneteng [74], e bakang "ho senyeha kelellong le maikutlong ha o lebeletsoe, ka nako e nyenyefalitsoeng le ho nyenyefatsoa". Boiketsetso bona bo se bo hlalositsoe mabapi le mesebetsi e meng ea inthanete [75], e ts'ehetsang maikutlo a hore ts'ebeliso e mpe ea cybersex e ka amana le ts'ebeliso e mpe ea inthanete le thobalano [76].
Kamora nako, re tlameha ho bolela hore mokhatlo o bonts'a "ho hloka thobalano ho tlamang" o kenyelletsoa khatisong e hlakileng ea ICD-11, khaolong ea "tšusumetso ea taolo ea ts'usumetso"77]. Tlhaloso e ka botsoa ho https://icd.who.int/dev11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1630268048.
Ho kenyelletsoa ha mokha ona ho ICD-11 e kanna ea ba karabelo molemong oa makasine ena le ho paka ts'ebeliso ea eona ea bongaka, athe data e ntseng e hola empa e sa kopane e re thibela ho e khetholla ka nepo e le bothata ba bophelo bo botle ba kelello [72]. Ho lumeloa hore e fana ka sesebelisoa se betere (se ntse se le ts'ebetsong ea ntlafatso) bakeng sa ho sebetsana le litlhoko tsa kalafo tse batlang bakuli le molato o ka amanang le [78], hape e ka supa lipuisano tse ntseng li tsoela pele mabapi le karohano e nepahetseng ka ho fetisisa ea CSB le palo e lekanyelitsoeng ea lintlha libakeng tse ling [55,71] (Lethathamo 1). Ho kenyelletsoa hona e kanna ea ba mohato oa pele oa ho lemoha taba ena le ho atoloha ho eona, ntlha e le 'ngoe ntle le pelaelo ntle le tšebeliso ea eona ea litšoantšo tsa bootsoa inthaneteng.
Tafole 1. Mekhoa ea DSM-5 le ICD-11 ea ho khetholla boitšoaro bo feteletseng.
Lethathamo

3.3. Liponahatso tsa Kliniki

Lipontšo tsa kliniki ea POPU li ka akaretsoa ka lintlha tse tharo tsa bohlokoa:

  • Ho se sebetse hantle ka mokhoa oa Erectile: ha lithuto tse ling li fumane bopaki bo fokolang ba kamano pakeng tsa tšebeliso ea litšoantšo tse litšila tse tsosang takatso ka thobalano.33], ba bang ba fana ka maikutlo a hore ho phahama ha tšebeliso ea litšoantšo tse litšila tse tsosang takatso e kanna ea ba lebaka la bohlokoa le hlalosang ho phahama ho hoholo ha ts'ebeliso ea erectile har'a bacha.80]. Phuputsong e 'ngoe, 60% ea bakuli ba nang le bothata ba ho se sebetse ka thobalano le molekane oa' nete, sebopeho ha se na bothata bona ba litšoantšo tsa bootsoa [8]. Ba bang ba pheha khang pakeng tsa tšebeliso ea litšoantšo tse litšila tse tsosang takatso ea botona le botšehali ho thata ho e qaqisa, hobane melao ea 'nete e sa senoloang litšoantšong tsa bootsoa hangata e fumaneha.81] mme ba hlahisitse moralo o ka bang teng oa lipatlisiso ntlheng ena.
  • Ho se khotsofalle likamano tsa batho ba bang le ba bang: Tšebeliso ea litšoantšo tse litšila tse tsosang takatso e amana le ho se khotsofalle thobalano le ho hloka thobalano ho banna le basali.82], kaha o nyatsa 'mele oa motho kapa oa balekane haholo, o eketsa khatello ea ts'ebetso le thobalano e fokolang haholo [83], ho ba le baratuoa ba bangata ba thobalano le ho etsa thobalano e lefuoang.34]. Tšusumetso ena e tsejoa haholo likamanong ha e le 'ngoe [84], ka tsela e ts'oanang le ts'ebeliso ea matekoane, ho arolelana lintlha tsa bohlokoa joalo ka lekunutu le phahameng [85]. Lithuto tsena li ipapisitse le tšebeliso ea litšoantšo tsa bootsoa tse seng tsa ka mehla, empa litšoantšo tsa bootsoa tse fumanehang marang-rang li kanna tsa se be le litlamorao tse mpe ha feela e se e le temallo [24]. Sena se ka hlalosa kamano pakeng tsa tšebeliso ea litšoantšo tsa bootsoa tsa basali le liphetho tse ntle ho basali [86].
  • Comorbidities: Boitšoaro bo feteletseng bo amanang le ho tšoenyeha, ho lateloa ke ho feto-fetoha ha maikutlo, ho se sebetse ka tšebeliso ea lithethefatsi le ho se sebetse hantle thobalanong [87]. Liphumano tsena li sebetsa le ho POPU [88], hape e amanang le ho tsuba, ho nwa joala kapa kofi, tšebeliso e mpe ea lithethefatsi [41] le ts'ebeliso e mpe ea papali ea video [89,90].
Ho ba le lithahasello tse ling tsa litšoantšo tsa bootsoa ka ho khetheha ho amana le keketseho ea mathata a tlalehiloeng [17]. Ho phehiloe khang haeba likarolo tsena tsa bongaka e le litlamorao tsa tlhekefetso ea cybersex ka kotloloho kapa ka lebaka la lithuto tse iponahatsang e le lithethefatsi [91].

3.4. Bopaki ba Neurobiological bo Tšehetsang Joala Mohlala

Ho bokella bopaki ka POPU ke ts'ebetso e boima; data ea bohlokoa ntlheng ena e ntse e fokotsoa ke mehlala e menyenyane ea sampole, mohlala feela oa banna ba bong bo fapaneng le meralo e arohaneng ea likarolo [71], ka lithuto tse sa lekaneng tsa neuroimaging le neuropsychological [4], mohlomong ka lebaka la litšitiso tse hlakileng, tsa lichelete le tse matla. Ntle le moo, ha bokhoba ba lithethefatsi bo ka bonoa le ho etsisoa liphoofolong tsa liteko, re ka se khone ho etsa sena ka ho lemalla lithethefatsi; hona ho ka fokotsa ho ithuta ha rona ka matla a eona a kutloisiso ea methapo [72]. Likheo tsa tsebo ea hajoale mabapi le patlisiso ea boitšoaro bo feteletseng, hammoho le mekhoa e ka etsoang ho li rarolla, li koaetsoe ka boiphihlelo le ho akaretsoa ka sengoloa sa Kraus [71]. Boholo ba lithuto tse fumanoeng lipatlisisong tsa rona li mabapi le boitšoaro bo nyarosang, ka litšoantšo tse litšila tse tsosang takatso ke e 'ngoe feela ea lisebelisoa tsa eona tse tlalehiloeng.
Bopaki bona bo thehiloe kutloisisong e hlahisang ts'ebetso ea neural lipakeng tsa liphetoho tse amanang le bokhoba ba neuroplasticity. Maemo a Dopamine a bapala karolo ea bohlokoa mohopolong ona oa moputso oa thobalano, joalo ka ha o bonoa ho dementia ea pele ho lefu le kalafo ea dopaminergic ho lefu la Parkinson le amanang le boitšoaro ba thobalano [92,93].
Ts'ebetso e lemaletseng litšoantšo tse manyala tse hlephisang boitšoaro inthaneteng e ka holisoa ke lipale tse potlakileng le "susumetso e kholo" (e hlahisitsoeng ke moputso oa moputso oa Nobel Nikolaas Tinbergen) e etsang litšoantšo tsa bootsoa Inthaneteng [94]. Ketsahalo ena e kanna ea baka tšusumetso ea maiketsetso (boemong bona, litšoantšo tsa bootsoa ka tsela e sebelisoang haholo kajeno, sebopeho sa inthanete) li fetisa karabelo ea tlhaho ea tlhaho e iphetotseng. Taba ke hore ba ka etsa hore tšebetso ea moputso oa rona oa tlhaho o atlehe maemong a phahameng ho feta seo baholo-holo ba kopaneng le sona ha likelello tsa rona li bile teng, 'me seo se etsa hore a tlamehe ho fetolela mokhoa oa bokhoba [2]. Haeba re nahana ka litšoantšo tse litšila tse tsosang takatso inthaneteng ho tloha ka tsona, re ka qala ho bona ho ts'oana le ho lemalla lithethefatsi.

Liphetoho tse kholo tsa bokong li lemaletse lithethefatsi li rala motheo bakeng sa lipatlisiso tsa nako e tlang tsa boits'oaro bo lemaletseng [95], ho kenyelletsa:

  • Sensitization [96]
  • Boikemisetso [97]
  • Dysfunctional prependal circuits (hypofrontality) [98]
  • Ts'ebetso ea khatello ea kelello e sa sebetseng [99]
Liphetoho tsena tsa bokong li hlokometsoe le bakuli ba nang le ts'ebetso ea hypersexual kapa basebelisi ba litšoantšo tsa bootsoa ka lipatlisiso tse ka bang 40 tsa mefuta e fapaneng: imagingance imaging, electroencephalography (EEG), neuroendocrine, le neuropsychological.
Mohlala, ho na le phapang e totobetseng ea tšebetso ea boko lipakeng tsa bakuli ba nang le boitšoaro bo laolehileng bo amanang le thobalano, bo ts'oanang le ba ba lemaletseng lithethefatsi. Ha ho pepesoa litšoantšo tsa thobalano, litaba tse amang maikutlo li bontšitse phapang lipakeng tsa ho rata (tumellanong le taolo) le takatso (takatso ea thobalano), e neng e le kholo haholo [8,100]. Ka mantsoe a mang, lithutong tsena ho na le takatso e fetang feela bakeng sa setheo se itseng sa thobalano, empa eseng takatso e akaretsang ea thobalano. Sena se re supa mohlaleng oa thobalano ka boyona eo ka nako eo e nkoang e le moputso [46].
Bopaki ba sena sa neural sign signaling takatso ke sa bohlokoa ka ho khetheha ho prefrontal cortex [101] le amygdala [102,103], e leng bopaki ba ho khothatsa. Ho kenya letsoho libakeng tsena tsa boko ho hopotsa moputso oa lichelete [104] 'me e ka ba le phello e tšoanang. Ho feta moo, ho na le litlaleho tse phahameng tsa EEG ho basebelisi bana, hammoho le takatso e fokotsehileng ea ho kopanela liphate le molekane, empa eseng ka ho ipholla litho tsa botona kapa botšehali [105], ho hong ho bonahatsang phapang pakeng tsa boleng ba boleng [8]. Sena se ka nkoa e le letšoao la ts'oaetso. Leha ho le joalo, ho ithuta ha Steele ho na le mekhoa e 'maloa ea mokhoa oa ho hlahloba (ka taba ea ho heterogeneity, ho hloka ho hlahloba mathata a kelello kapa ho lemalla, ho se be le sehlopha sa taolo, le tšebeliso ea lipotso tse sa tiisetsoeng bakeng sa tšebeliso ea litšoantšo tsa bootsoa) [106]. Thuto ea Prause [107], lekhetlong lena le sehlopha sa taolo, se pheta liphihlelo tsena. Boikarabello ba ts'ebetso ea ho ts'oaroa ha maikutlo le takatso ea ho ts'ebelisoa ha lithethefatsi tsa litaba tsa inthaneteng li 'nile tsa khothatsoa ka basali ba bong bo fapaneng [108] le litekanyetso tsa banna ba ratanang le ba bong bo tšoanang [109].
Khethollo ena e mabapi le lithahasello tsa thobalano e atile haholo bathong ba pelehi ba boitšoaro bo bobe [110], empa ho itlhahisa khafetsa ho bona ho bonts'a ho nyahama [111,112]. Sena se bolela ho fokotsoa ha lits'ebetso tsa meputso, tse ka ananeloang ke mokokotlo o moholo oa dorsal [107,113,114]. Kaha dorsal cingulate e kentse letsoho ho lebelletseng meputso le ho arabela liketsahalong tse ncha, ho fokotseha ha ts'ebetso ea eona kamora ho pepesetsoa khafetsa ho re supisa nts'etsopele ea tloaelo le mohopolo oa pele. Sena se fella ka khethollo e ntlafalitsoeng ea tšebetso bakeng sa bonyatsi bo sa tsoaneng [115], e ka bonts'ang e le liteko tsa ho hlola bolulo le ho nyahama ka ho batla litšoantšo tse ncha (tse ncha) e le mokhoa oa khotsofalo ea thobalano, ho khetha boitšoaro bona ho fapana le thobalano ea 'nete [20].
Boiteko bona ba ho batla bocha bo ka kopanngoa ka ho fetoha ha boits'oaro [116] le amygdala [117]. Hoa tsebahala hore ho shebella litšoantšo tsa bootsoa ho basebelisi khafetsa ho boetse ho amana le ts'ebetso e kholo ea neural [99], haholo-holo ka har'a ventral striatum [116,118] e bapala karolo e kholo ho lebelletseng meputso [119].
Leha ho le joalo, khokahano lipakeng tsa ventral striatum le preortal cortex e fokotsehile [103,113]; ho fokotseha ha khokahano lipakeng tsa preortal cortex le amygdala le hona ho hlokometsoe [117]. Ntle le moo, lithuto tsa hypersexual li bontsitse khokahano e sebetsang ea lipakeng tsa li-lobes tsa caudate le tsa nakoana tsa cortex, hammoho le khaello ea taba e putsoa libakeng tsena [120]. Liphetoho tsena kaofela li ka hlalosa ho se khone ho laola maikutlo a boitšoaro ba thobalano.
Ho feta moo, lithuto tsa hypersexual li bontšitse molumo o eketsehileng oa amygdala [117], ho fapana le ba pepesehelang ntho, ba bonts'a molumo o theohileng oa amygdala [121]; phapano ena e ka hlalosoa ke phello ea neurotoxic ea ntho. Lithutong tse buang ka khatello ea maikutlo, ts'ebetso e eketsehileng le molumo li ka bonts'a ho fetellisa ka mekhoa ea bokhoba (haholo-holo tšehetsang likhopolo tsa tšusumetso) kapa ho ba litlamorao ho mekhoa e sa feleng ea khatello ea maikutlo sechabeng, joalo ka tšibollo ea boitšoaro ka bo eona [122].
Basebelisi bana ba boetse ba bonts'itse karabelo ea khatello ea maikutlo e sa sebetseng hantle, e shebaneng haholo le hypothalamus-pituitary-adrenal axis [122] ka tsela e lekanang liphetoho tseo tse bonoang ho batho ba lemaletseng lithethefatsi. Liphetoho tsena e kanna ea ba tse bakiloeng ke liphetoho tsa epigenetic ho babuelli ba methapo ba maqhubu ba ho khanna lithethefatsi, joalo ka corticotropin-releasing-factor (CRF) [123]. Tekanyetso ena ea "epigenetic regulation" e nka liphetho tsa hedonic le anhedonic bonyane li ameha ka tsela e itseng ke liphatsa tsa lefutso tsa dopaminergic, mme mohlomong li-polotorans tsa genot tse ling tse amanang le li-genotransmitter.124]. Ho boetse ho na le bopaki ba litla-morao tsa tumor necrosis factor (TNF) ho batho ba lemaletseng ho etsa thobalano, ka kamano e matla pakeng tsa maemo a TNF le lintlha tse phahameng maemong a tekanyetso ea hypersexuality [125].

3.5. Bopaki ba Neuropsychological

Mabapi le liponahatso tsa liphetoho tsena ka boits'oaro ba thobalano, lithuto tse ngata tsa neuropsychological li bonts'a mofuta o mong o sa tobang kapa o tobileng ka kotloloho mosebetsing o moholo [126,127], mohlomong e le phello ea liphetoho tsa pele tsa cortex [128]. Ha e sebelisoa ho litšoantšo tsa bootsoa tsa inthaneteng, e kenya letsoho kholisong ea eona le ho e lokiseng [129,130].
Lintho tse hlalosoang ke tšebetso ena e futsanehileng ea batho ba futsanehileng li kenyelletsa: ho ba le khatello ea maikutlo [131,132], ho ba le kelello ha kelello ho sitisang mekhoa ea ho ithuta kapa ho khona ho fetisa tlhokomelo [120,133,134], kahlolo e mpe le ho nka liqeto [130,135], tšitiso ea matla a memori a sebetsang [130], likhaello tsa taolo ea maikutlo, le ho ameha haholo ka thobalano [136]. Liphumano tsena li re hopotsa litlhare tse ling tsa boits'oaro (joalo ka papali ea chelete) le boits'oaro ho litheko tsa lintho [137]. Boithuto bo bong bo hanana ka ho toba le liphetho tsena [58], empa ho na le ho ka 'na ha e-ba le mefokolo ho mokhoa (mohlala, mohlala o fokolang).
Ho fihlela lintlha tse kenyang karolo ntlafatsong ea boitšoaro bo fetelletseng ba boitšoaro le ho hlasela ka bongoli ba litaba, ho na le tse 'maloa tsa tsona. Re ka nahana ka ntlafatso ea cue, matlafatso a matlafatsang le thuto e kopaneng [104,109,136,138,139] e le methati e ka sehloohong ea nts'etsopele ea lithethefatsi tse litšila tse tsosang takatso. Leha ho le joalo, ho ka ba le mabaka a tlhekefetso e tlase [140], joalo ka: (1) karolo ea khotsofalo ea thobalano le ho se sebetse hantle ho ts'ebetsong ho batho ba bang ba reriloeng pele [40,141,142,143] hore na ke phello ea ho susumetsoa ke tšobotsi [144,145] kapa mmuso146], le (2) mekhoa ea ho qoba ho qoba [147,148,149].

3.6. Kelello

Boholo ba lithuto li qotsitsoeng li sebelisa lithuto tse nang le nako e telele ea litšoantšo tse litšila tse tsosang takatso inthaneteng [34,81,113,114], ka hona liponahatso tsa eona tsa bongaka li bonahala e le sephetho se tobileng le se lekanang sa ho kenya letsoho ts'ebetsong ena e mpe. Re boletse bothata ba ho fumana taolo ea ho theha Causation, empa litlaleho tse ling tsa nyeoe li fana ka maikutlo a hore ho fokotsa kapa ho tlohela mokhoa ona ho ka baka ntlafatso ho se khotsofatseng ha thobalano le maikutlo a thobalano a batho ba sa ratanang le batho ba bong bo fapaneng [79,80] esita le ho hlaphoheloa ka botlalo; hona ho ka bolela hore liphetoho tse boletsoeng pele tsa bongo li ka fetoha.

3.7. Lisebelisoa tsa Tlhahlobo

Ho na le lisebelisoa tse 'maloa tsa ho hlahloba CSB le POPU. Bohle ba itšetleha ka botsepehi le botshepehi ba mofani; mohlomong le ho feta ho feta tlhahlobo ea tlhahlobo ea kelello ea kelello, hobane litloaelo tsa thobalano ke tsona tse nyenyefatsang ka ho fetesisa ka lebaka la tlhaho ea bona ea lekunutu.
Bakeng sa hypersexuality, ho na le lipotso tse fetang tsa 20 tse hlahlobang lipotso le tlhahlobo ea lipotso tsa tliliniki. Tse ling tsa tse hlokomelehang haholo li kenyelletsa Tlhahlobo ea Tlatsetso ea Thobalano ka Thobalano (SAST) e khothalletsoang ke Carnes [150], le mofuta oa eona oa morao-rao o ntlafalitsoeng SAST-R [151], Inventory ea Boitlamo ba ho Kopanela Liphate ka Thobalano (CSBI) [152,153] le Hypersexual Disorder Screening Inventory (HDSI) [154]. HDSI qalong e ne e sebelisoa bakeng sa tlhahlobo ea bongaka ea tlhahiso ea tšimo ea DSM-5 ea hypersexual disc. Ha ho ntse ho etsoa lipatlisiso tse ling hape mabapi le phello e matla mabapi le litekanyetso le ntlafatso ea lintlha tse fokotsoang, hona joale e na le ts'ehetso e matla ea psychometric mme ke sesebelisoa se nepahetseng ho feta ho lekanya hypersexual disorder [151].
Ha e le mabapi le litšoantšo tsa bootsoa tse fumanehang marang-rang, sesebelisoa se sebelisoang ka ho fetisisa ke tlhahlobo ea liteko tsa botona le botšehali inthaneteng (ISST) [155]. E hlahloba maemo a mahlano a fapaneng (ho qobelloa ka thobalano marang-rang, boitšoaro ba thobalano ba marang-rang, boitšoaro ba thobalano bo fumanehang marang-rang, tšebeliso ea thobalano marang-rang le ho khahloa ke boits'oaro ba thobalano marang-rang) ka lipotso tsa 25 dichotomic (e / che). Leha ho le joalo, thepa ea eona ea psychometric ha e ea hlahlojoa habobebe feela, ka netefatso e tiileng ea Sepanishe [156] e sebelisitseng e le polane ea lithuto tsa ka morao-rao [157].
Lisebelisoa tse ling tse hlokomelehang ke sekhahla sa bothata ba tšebeliso ea litšoantšo tsa bootsoa (PPUS) [158] e lekanyang likarolo tse 'ne tsa POPU (ho kenyelletsa: mathata a ts'ebetso le ts'ebetso, ts'ebeliso e feteletseng, mathata a taolo le ts'ebeliso ea ho baleha / ho qoba maikutlo a mabe), tlhahlobo e khutšoane ea tšebeliso ea marang-rang e ikamahantseng le liketso tsa thobalano tsa inthaneteng (s-IAT-thobalano) [159], lipotso tsa 12 tsa ntho e lekanyang likarolo tse peli tsa POPU, le lethathamo la tšebeliso ea litšoantšo tse litšila tse tsosang takatso ka thobalano (CPUI-9) [160].
CPUI-9 e lekola likarolo tse tharo: (1) liteko tsa ho fihlella, (2) tse lemohileng ho qobella, le (3) khatello ea maikutlo. Qalong ho nahanoa hore o na le thepa e kholisang ea psychometric [9], lethathamo lena le sa tsoa bonahala le sa ts'epahala: kenyelletso ea "khatello ea maikutlo" maemong a aterese ea lihlong le letsoalo le molato, tse sa tsamaeng tlhatlhobo ea bokhoba 'me ka hona li ts'oarella likalo ho ea holimo [161]. Ho sebelisa lethathamo lena ntle le tekanyo ena ho bonahala ho bonts'a tšebeliso e nepahetseng ea ts'ebeliso ea litšoantšo tsa bootsoa.
E 'ngoe ea morao-rao ke sekhahla sa tšebeliso ea litšoantšo tse litšila tse tsosang takatso ea boitšoaro bo bobe (PPCS) [162], e ipapisitse le mofuta oa tšebeliso ea karolo ea botšelela ea Griffith [163], leha e sa lekanyetse bokhoba, tšebeliso ea mathata a litšoantšo tse litšila tse tsosang takatso e nang le thepa e matla ea psychometric.
Mehato e meng ea POPU e sa etselitsoeng ho lekanya tšebeliso ea litšoantšo tsa bootsoa inthaneteng empa e netefalitsoe ke basebelisi ba litšoantšo tsa bootsoa inthaneteng [9], kenyelletsa "Inthanete ea Litšoantšo tsa Bootsoa" (PCI) [164,165], Scale e Akaretsang ea Litšoantšo tsa Bootsoa e Qobelloang (CPCS) [166] le lipotso tse tsosang takatso ea ho sheba litšoantšo tsa bootsoa.167] e ka lekanyang lisosa tsa maemo har'a mefuta e fapaneng ea mosebelisi oa litšoantšo tsa bootsoa.
Ho boetse ho na le lisebelisoa tsa ho hlahloba boikemisetso ba basebelisi ba litšoantšo tsa bootsoa ho tlohela boitšoaro ka mekhoa e iqapetsoeng [168] le tlhahlobo ea sephetho sa kalafo ka ho etsa joalo [169], ho tsebahatsa tse ka bang tse tharo tse ka u thusang ho khutla hape: (a) ho tsosa takatso ea botona kapa botšehali / monyetla, (b) botaoa / libaka / phihlello e bonolo, le (c) maikutlo a mabe.

3.8. Phekolo

Kaha ho sa ntse ho e-na le lipotso tse ngata mabapi le conceptualization, tekolo, le lisosa tsa boitšoaro bo hokahaneng le POPU, ho bile le liteko tse fokolang tsa ho etsa lipatlisiso ka mekhoa e ka khonehang ea kalafo. Lithutong tse phatlalalitsoeng, mehlala ea sampole hangata e nyane ebile ha e sebetse haholo, taolo ea bongaka e ea fokola, le mekhoa ea lipatlisiso e hasantsoe, ha e ts'episoe, ebile ha e pheptjoe [170].
Hangata, ho kopanya mekhoa ea kelello le kelello, boits'oaro, psychodynamic le pharmacologic li nkoa li sebetsa hantle haholo kalafo ea bokhoba ba thobalano, empa mokhoa ona o sa tobang o bonts'a ho hloka tsebo ka taba eo [9].

3.8.1. Mekhoa ea lithethefatsi

Lithuto li shebile paroxetine le naltrexone ho fihlela joale. Letoto le le leng la paroxetine ho POPU le thusitse ho fokotsa maemo a matšoenyeho, empa qetellong a hloleha ho fokotsa boitšoaro ka bo bona [171]. Ntle le moo, ho sebelisa SSRIs ho theha bothata ba thobalano ka litla-morao tsa bona ha ho na thuso, 'me ho latela boiphihlelo ba bongaka bo na le thuso ho bakuli ba nang le mathata a kelello a "comorbid psychiatric [172].
Litlaleho tsa linyeoe tse 'ne tse amanang le naltrexone ho phekola POPU li hlalositsoe. Liphumano tse fetileng li bontšitse hore naltrexone e ka ba kalafo e ka ba teng bakeng sa bokhoba ba boits'oaro le khatello ea kelello [173,174], ka thellelori e fokotsa litakatso le likhakanyo ka ho thibela mofufutso o amanang le boits'oaro. Le ha ho e-so be le teko e laoloang ka boomo le naltrexone lithutong tsena, ho na le litlaleho tsa linyeoe tse 'ne. Liphetho tse fumanoeng ho fokotsa tšebeliso ea litšoantšo tse litšila tse tsosang takatso li fapane le tse ntle [175,176,177] ho ba bonolo [178]; bonyane ho e 'ngoe ea tsona mokuli le eena o amohetse sertraline, ka hona ha ho hlake hore na ho ka boleloa bokae ka naltrexone [176].

3.8.2. Mekhoa ea Psychotherapeutic

Ntle ho pelaelo, psychotherapy e ka ba sesebelisoa sa bohlokoa ho utloisisa le ho fetola boits'oaro. Le ha kalafo ea methapo ea kutlo (CBT) e nkuoa ke lingaka tse ngata e le tsa bohlokoa ho phekola lefu la hypersexual [179], boithuto bo kenyelletsang basebelisi ba litšoantšo tsa bootsoa ba inthanete bo sitileng ho fihlela phallo ea boitšoaro [180], leha e le ho teba ha matšoao a sithabetsang a maikutlo a bophelo bo botle le boleng ba bophelo ka kakaretso bo ntlafalitsoe. Sena se tlisa khopolo ea thahasello ea hore ho fokotsa ts'ebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro ho ka se emele sepheo sa bohlokoa sa kalafo [170]. Mekhoa e meng e sebelisang CBT ho phekola POPU e se e entsoe, empa mathata a bothateng a ho rarolla bothata sebakeng sena a re thibela ho hlahisa liqeto tse tšepahalang [181,182].
Psychodynamic psychotherapy le tse ling tse kang kalafo ea malapa, kalafo ea balekane, le kalafo ea kelello e tsamaeang ka mor'a mananeo a mehato ea 12 li ka ipaka e le tsa bohlokoa ha li rarolla lihlooho tsa lihlong le letsoalo le ho khutlisetsa ts'epo har'a kamano e haufi ea basebelisi [170,172]. Teko e le 'ngoe feela e laoloang e sa sebetseng e teng le basebelisi ba nang le bothata ba litšoantšo tsa bootsoa tsa inthanete e lebisa tlhokomelo ho Amohelang le boitlamo ba boitlamo183], ntlafatso e tsoang lethathamong la linyeoe tsa bona tsa 2010 [184], eo e neng e le thuto ea pele ea tlhahlobo ea ho sebetsana le POPU. Phuputso e bonts'itse liphetho tse ntle empa ho thata ho e tlosa hobane sampole e ne e le nyane haholo hape e tsepamisitse maikutlo ho sechaba se ikhethileng.
Katleho e tlalehiloeng ka CBT, kalafo ea kopanelo le ACT li ka itšetleha ka 'nete e thehiloeng ho mindility le melaoana ea ho amohela; ho latela moelelo oa taba, kamohelo ea tšebeliso ea litšoantšo tse litšila tse tsosang takatso e ka ba e lekanang kapa ea bohlokoa ho feta ho fokotsa ts'ebeliso ea eona [170].

4. Puisano

Ho bonahala eka POPU ha se ntho e le 'ngoe feela e amanang le khatello ea maikutlo, empa hona joale e atile haholo kaha e boetse e kenyeletsa ho ipholla litho tsa botona kapa botšehali. Le ha hona ho le thata ho tseba hore na ke hobaneng ho sa tsejoe le ho fumaneha ha lintho tse etsang hore ts'ebeliso ea litšoantšo tse litšila tse ts'oeroang kajeno e atisoe, bonyane re ka netefatsa hore mofani oa tšebeliso ea litšoantšo tsa bootsoa o fetohile hoo e ka bang lilemo tse leshome tse fetileng. Ho ke ke ha ba bohlale ho nahana hore mefuta ea eona ea inthanete e bile le tšusumetso e kholo ho bareki ba eona, le hore lintlha tse tharo li matlafatsa kotsi e ka bang teng ho POPU le boits'oaro bo bong ba thobalano.
Joalokaha re boletse, ho se tsebe lebitso ke ntho ea bohlokoa e ka etsang hore boitšoaro ba thobalano bo fetohe bothata. Re hloka ho hopola hore lipalo-palo mabapi le bothata bona ho hlakile hore li lekanyelitsoe ho batho ba lilemo tsa molao feela ho etsa thobalano, inthaneteng kapa ka tsela e ngoe; empa ha ho re phonyohe hore liketso tsa thobalano ha li qale kamora nako ena, mme ho na le monyetla oa hore bana ba sa ntseng ba le mothating oa ho etsa thobalano ke batho ba tlokotsing ka ho khetheha. 'Nete ke hore tumellano e matla ea hore na ke boitšoaro bofe ba thobalano bo amanang le thobalano, bo fumanehang kantle ho marang-rang le marang-rang, bo hlokahalang ho bo lekanya ka mokhoa o nepahetseng le ho netefatsa hore na bo na le bothata bo bokae sechabeng sa kajeno.
Ho latela seo re se tsebang, lipatlisiso tse 'maloa tsa morao-rao li tšehetsa mokhatlo ona e le lithethefatsi le lits'oants'o tsa bohlokoa tsa kliniki tse kang ho se sebetse ka thobalano le khotsofalo ea kelello. Boholo ba mosebetsi o teng o thehiloe lipatlisisong tse tšoanang tse entsoeng ka lithethefatsi tsa lithethefatsi, ho itšetlehile ka khopolo-taba ea litšoantšo tse manyala tse hlephisang boitšoaro e le 'boipheliso bo phahameng' ho ea ho ntho e le 'ngoe eo ka eona ho sebelisoang ho sebelisoang, ho ka hlahisang boloetse ba ho lemalla. Leha ho le joalo, likhopolo tse kang ho mamellana le ho ipolaea ha li e-s'o behoe ka ho lekaneng hore li tšoanelehe ho khetholla lithethefatsi, 'me kahoo li etsa karolo ea bohlokoa ea lipatlisiso tsa nakong e tlang. Ka motsotso ona, mokhatlo oa lefu lena o akarelletsang boitšoaro bo bobe ba ho kopanela liphate o kenyelelitsoe ICD-11 ka lebaka la bohlokoa ba hona joale ba kliniki, 'me ka sebele o tla sebelisoa ho rarolla bakuli ba nang le matšoao ana a kenyang lingaka thuso.
Lisebelisoa tse fapaneng tsa tlhatlhobo li teng ho thusa ngaka e tloaelehileng ka mekhoa ea tlhahlobo ea bongaka, empa ho fokotsa seo e leng 'nete ebile e se ka mokhoa o nepahetseng e ntse e le bothata bo ntseng bo tsoela pele. Ho fihlela joale, karolo ea bohlokoa ea litekanyetso tse tharo tse khethiloeng ke Carnes, Goodman, le Kafka li kenyelletsa mohopolo oa taolo ea taolo, nako e fetisitsoeng ea boitšoaro ba thobalano le litlamorao tse mpe ho eena le ho ba bang. Ka tsela e itseng, ba teng le lithulusi tse ngata tse hlahlobiloeng tse hlahlojoang.
E kanna ea ba moaho o lekaneng oo u ka hahang holim'a ona. Lintho tse ling, tse nkuoang e le tsa bohlokoa tse fapaneng, mohlomong li re supa hore re nahane ka lintlha ka bonngoe. Ho etsa sesebelisoa sa tlhahlobo se bolokang maemo a fetohang ha o ntse o bohlokoa bakeng sa ho fumana hore na bothata ke eng, hape ke phephetso e 'ngoe eo re tobaneng le eona,' me mohlomong e tla tsamaisana le lipatlisiso tse ling tsa neurobiological tse re thusang ho utloisisa haholoanyane ha tekanyo e itseng ea bophelo bo tloaelehileng ba motho bo fetoha ho tloha tloaelong e tloaelehileng ho ea ho pherekano.
Ha e le maano a kalafo, sepheo sa mantlha hajoale se shebane le ho fokotsa tšebeliso ea litšoantšo tsa bootsoa kapa ho li tlohela ka ho felletseng, hobane lipontšo tsa kliniki li bonahala eka li ka fetoha. Mokhoa oa ho fihlela sena o fapana ho ea ka mokuli mme o ka hloka ho fetoha le maemo ho merero e sebelisitsoeng, ka kelello le kamohelo e thehiloeng kelellong e lekanang kapa e le bohlokoa ho feta mokhoa oa theknoloji maemong a mang.

dithuso tsa ditjhelete

Patlisiso ena ha ea ka ea fumana chelete ea lichelete.

Likhohlano tsa Thahasello

Rubén de Alarcón, Javier I. de la Iglesia, le Nerea M. Casado ha ba phatlalatse hore ha ho na khohlano ea letho. AL Montejo o amohetse litefiso tsa boeletsi kapa lithuso tsa honaria / lipatlisiso lilemong tse hlano tse fetileng ho tsoa ho Boehringer Ingelheim, Lifektheri tsa Litaba, Rovi, Servier, Lundbeck, Otsuka, Janssen Cilag, Pfizer, Roche, Instituto de Salud Carlos III, le Junta de Castilla y León .

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